Contact Wounds: A War Surgeon's Education

Contact Wounds: A War Surgeon's Education

by Jonathan Kaplan

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Overview

Surgery is the crude art of cutting people open, yet it is also a symphony of delicate manipulation and subtle chords. So says Jonathan Kaplan in his stunning book Contact Wounds, an electrifying account of a doctor’s education in the classroom, in life, and on the battlefield. Inspired by his father, a military surgeon in World War II and Israel’s nascent fight for statehood, Kaplan became a doctor and was appointed to a post at a woefully understaffed South African general hospital in a black township. Fleeing apartheid, he traveled the globe in search of sanctuary, experiencing riots, tropical fevers, political upheaval, and a jungle search for a lost friend. Kaplan eventually landed in Angola, taking charge of a combat-zone hospital, the only surgeon for 160,000 civilians, where he was exposed daily to the horrors of war. Journeying further into dangerous territory, Kaplan portrays serving as a volunteer surgeon in Baghdad—where he treated civilian casualties amid gunfights for control of hospitals and dealt with gangs of AK-47-wielding looters stripping pharmacies. Contact Wounds is a stirring testament of adventure, discovery, survival, and the making of a career devoted to saving people caught in the crossfire of war.

Product Details

ISBN-13: 9780802142788
Publisher: Grove/Atlantic, Inc.
Publication date: 09/12/2006
Edition description: First Trade Paper Edition
Pages: 288
Product dimensions: 5.50(w) x 8.25(h) x (d)

Read an Excerpt

CHAPTER 1

Hereditary Conditions

I used to think we were unlucky that we hadn't had a proper War, and looked for its traces all around me. The buildings along the beachfront were graceful blocks of flats, their corners rounded like an old radio. They had names that I've forgotten, but they held a particular charm for me because, as the adults said so casually, they were 'prewar'; they had seen history. I imagined cocktail parties on those balconies, guests looking up at the sound of bombers overhead. In truth there hadn't been any bombers over Durban, at least none that flew in anger or rained incendiaries on the town below. The anti-aircraft guns on the Bluff did open up one night in 1941 on an empty sky and a house was demolished by a falling shell; a bit of a joke, really.

But the war had left its mark here, in the names scored on the memorial near the city hall, and grey ships loaded with tanks and men had once sat off the harbour mouth, forming convoys against the enemy submarines that might be stalking them against the imperfect beachfront blackout. My parents and their friends used to talk about those times as we sat on the beach, watching the deepwater swimmers out by the shark-nets. Stories about dancing at the Cosmo Club on leave, getting insults from the Afrikaner Studentebond for being in uniform: not the sort of action I was interested in. When I pressed them they would shake their heads.

'It's 1960,' I was told, 'the war's been over for fifteen years. You don't have to worry about that stuff anymore. Let's have some peace and quiet.'

So I kept quiet and read my war books and tried to make sense of what was going on in the newspapers. The pictures showed police in their flat caps bending over untidy shapes of clothing. The faces were turned away, but I recognised those shapes from pictures of other battlefields. I read the headlines and tried the name 'Sharpeville' on my tongue. It didn't have the same ring as Normandy or Dunkirk, but it meant something to the adults, that was certain, as they sat on the veranda and talked and smoked through the hot evening.

'There's going to be trouble, fighting,' someone said, and I shivered, imagining rubble and tanks rolling through the streets. In the morning as we were being driven to school I stuck my head out of the car window, scanning the sky for aircraft. The other kids sang along with the radio:

'Weatherman tell us
There was nothing to see but the morning sun, bouncing off the bay's calm.

It was only when my mother took us shopping in town, the sky black over the buildings before the afternoon thunderstorm, that I began to notice. Lots more cops than usual, elbowing back the unfamiliar weight of their slung rifles. The black people on the streets looked different too: quiet, and walking close to the walls as if they didn't want to attract attention. The police stopped them, lined them up and held out their hands for passbooks. It had a familiar look, like a scene from a movie about the German occupation in France. At the same time I was unimpressed because the cops didn't look like real soldiers and their voices cracked as they shouted.

'Kom, kaffer,' they screamed. 'Wys jou pas!' and I realised how tense they were.

'It's because there's trouble in the Native locations,' I was told by my friend Rolie. 'It's because the Zulus hate the Indians; always have.'

He and his mates suddenly appeared much better informed than I, who only heard evening talk that I wasn't supposed to be listening to, about vague things like 'the political situation'. My school-friends didn't know anything about the political situation – probably didn't know there was one – but they knew about rampages and massacres, had heard their parents talk about black servants who crept silently up the stairs of the white homes each night, carving knife in hand, to check that everyone was asleep.

'My father told me all about it,' said Rolie. 'He was there in '49 during the riots when they burnt the Indian shops. He was called up from the reserves, and they gave him six bullets and a rifle and put him on patrol in Umgeni Road. He said it was the women, the Native women, who stirred it all up, running in front with sticks, making that noise with their tongues. It's just a matter of time before they turn on us.'

And so they went on, comparing rumours, boasting about the size of their fathers' guns, while I listened, perplexed, wondering whether I lived in another country. There was no talk of rifles or homicidal servants at our dinner table, hardly any talk at all that I could follow, but in the evenings the murmur of voices would rise from the terrace below my bedroom, over the sound of trains shunting down at the docks. I leaned on the veranda rail watching the cigarettes glow: Mike and Shirley, Rose and Louie, all those young couples, ice tinkling in their glasses, asking my father about England where he'd been demobilised from the army after the end of the war.

'Oh, it's not so bad there, you know.'

'I couldn't bear it, too cold ...' and the women would stand watching the moon rise over the bay with the pressure of that thick, still air on their faces.

* * *

The air in Durban had a special embrace, a humidity that held the scent of turmeric and coated your body like honey. Flamingos used to come each year to wade on the mudflats in the bay, near the black whaling ships at anchor with their harpoon-guns shrouded. I imagined it must be very different in Europe, which was the setting of the war books that filled the Adventure section of my local library. I read them late into the night while outside the rainy-season downpour drummed on the giant leaves of the elephantearplants and awoke the belling of the tree-frogs. The books were generally about English heroes. I met one once, a legendary World War Two fighter pilot whose biography I'd read over and over. He had lost his legs in a peacetime training crash and was being rehabilitated on metal limbs when the war began. Convincing the Royal Air Force to let him fly again, he led a Group of fighter squadrons against the Germans. He was shot down over France, leaving one of his tin legs behind in the cockpit as he parachuted out, and a spare had to be dropped to him in the camp where he'd been imprisoned. He'd made several attempts to escape, ending the war in the fortress-prison of Colditz. Now the man used his free time to campaign internationally for the care of the disabled; encouraging them, raising money and awareness.

This work brought him to South Africa, to visit the residential handicapped centre in Durban where my father was staff orthopaedic surgeon. I was let off school to meet him. After being shown round and talking to the kids in their wheelchairs, the ex-group-captain sat at a table under the flame lily trees and sucked on his pipe and signed my copy of his book. Back at school my teachers, deeply envious, wanted to know everything about him. They came mostly from England and felt at home in Durban, they said, because this ex-colonial capital on the Indian Ocean reminded them of what Britain had been before standards had declined. Our headmaster had been a prisoner of war – we credited him with many daring, unsuccessful escapes – and wore a tweed jacket and cravat despite the heat. In a locked drawer of his desk he kept a real pistol, which he sometimes showed to groups of deserving boys.

* * *

My father had served in the war as a surgeon, treating wounded soldiers in tent field-hospitals. During the desert campaign in North Africa he had watched the barrage flame from horizon to horizon at the battle of El-Alamein, before the arrival of the first ambulances heralded a flood of casualties on which he and his colleagues worked beyond exhaustion. They'd occupied the lulls between battles, or treating wounded from skirmishes and air-raids, with equal application. Among the books in our study was one written by a group of brother medical officers, dated 1943, called Now There's a Thing: A Manual on the Philosophy and Practice of Liar Dice. It described lengthy engagements of dare and deception through medical, military and literary allusions, and was extremely funny. Chapters profiled the strategies of maestros of the game; one sketch showed someone who looked like my dad observing a throw through the smoke of his cigarette, dark hair combed back and a captain's pips on the shoulders of his rumpled bush-shirt.

His civilian orthopaedic practice now must have been less intense, but it was often the case that he'd come home from the hospital only after midnight, or be called away during dinner to deal with an emergency. I had a limitless belief in my father's abilities, enhanced by the mysterious kit of clinking bottles he carried in his car-trunk containing powdered plasma, for emergency infusion at the scene of a major accident. His consulting rooms were high in a granite building in downtown Durban, with his name in black on the frosted glass door and a bee-hive-shaped jar of sweets in his desk drawer that my brother and I were allowed to raid when we came to visit. From his window we could look down over the colonial heart of the city; the steps of the old post office where Winston Churchill had addressed the people of Durban after his escape from the Boers in 1900, the city hall flanked by cannons, and the palms around the war memorial with its relief of a mourning angel and the ranks of names. These were all white men's names. The black dead – many had served in the war, as drivers and in labour battalions and other roles that did not involve the carrying of arms – were unlisted. The first story I'd learned of a local war hero, however, was that of Lucas Majozi, a Zulu stretcher-bearer who had gone out under fire at El-Alamein again and again to bring in the wounded despite being wounded repeatedly himself.

It was the war that had taught my father his operating skills. Those years had brought enormous medical advances: in the treatment of shock, in antibiotics, blood transfusion and most significantly in reconstructive surgery, an area in which he'd come to specialise. One afternoon a German lady was brought by a visiting doctor to our house for tea. She'd had her hands blown off when the Hamburg munitions factory in which she had been working hadbeen bombed in 1944. German surgeons had carried out a pioneering reconstructive operation, separating the long bones of her forearms and repositioning tendons so that the muscles performed new movements. Instead of lying together, the bones could now be opened and closed like a crab's claws, allowing her to pick up her cup, place a biscuit between her lips. We sat around the tea table in the garden and I stared aghast as my dad touched those creepy appendages and felt the muscles flex as they pinched.

'That's beautiful,' he said. The German lady was pretty – she'd been a girl when the injury happened – and suddenly I saw her blush.

The orthopaedic work he did for the handicapped centre involved similar reconstructive techniques. Most of the children suffered from muscle spasticity due to cerebral palsy, and my father would perform tendon transfers – he'd explain to me the operations required, pointing out the muscles on my own skinny arms and legs – loosening contractions and shifting the pull of one over-active muscle to counter another so that a limb could be made straight; that's what the Greek word orthos meant. He addressed medical conferences on the surgical treatment of spinal tuberculosis, to straighten backs crooked by bone collapse and take pressure off the spinal cord. For the Zulu leprosy patients at the sanatorium up the coast he carried out operations to correct deformities caused by nerve damage from the disease. We always knew when he'd been working there, for – despite his knowledge of leprosy's low infectivity – he would fend off our greetings and step out of his work-clothes in the upstairs passage that led from the garage, in order to shower and change before joining us at the dinner table.

My mother usually came home smelling of disinfectant. She was a pathologist, working at the medical school. Pathology was as fascinating as surgery but more solemn, because it was about death. One of the heads of her department was carrying out research into the techniques of suicide favoured by each of the city's ethnic groups. Black men cut their throats. Black women drank bleach. Indian women set themselves alight, the men hanged themselves. White women took overdoses, while the most popular technique for white men – apart from a brief vogue of looping a rope round the neck, tying the other end to a tree, and driving off at speed – was their readily-to-hand firearms.

There were two kinds of white people, English and Afrikaans. The latter spoke a different language; also, while we had been fighting the Germans in World War Two, the Afrikaner opposition party headed by Dr Malan (a Doctor of Divinity, I was relieved to note, not of medicine) had wanted a Nazi victory. Afrikaner students attacked soldiers on leave. My mother had been at Pretoria University at the time, while her brothers were serving in North Africa. She remembered some of her classmates giving the Hitler salute, and the night a sabotage group had derailed a troop train by blowing up the line where it ran through the veld near her family home east of the city. Now the Afrikaners ran the country and made the laws, and the political discussions among my parents and their friends involved a certain seriousness of tone that tended to set them beyond the understanding of children.

Then politics came into our lives. A state of emergency was declared and police trucks roared late at night along the road that led past the university and down the back of the Ridge. I'd once been down there all the way to the end, where the tarmac became patchy and pot-holed and lights on poles lit the gates of the Cato Manor Native Township. I would hear the trucks returning, engines groaning up the hill, and I imagined the prisoners looking through the wire mesh at our house as they were driven past, seeing our lights, and wondered what they felt. Sometimes in the distance there would be sounds like gunshots. In the mornings the road was always empty, with the smell of wet tarmac in the rising heat.

* * *

It had rained that morning, making the classrooms dark and forcing us to spend our lunch-break under the dripping trees. Slate-coloured clouds heaped up behind the Ridge and the close air promised more rain on the way. We were back upstairs at our desks when we first heard it; a sort of deep, droning hum that came from far off, filling the room. We looked at Miss Charles, who stared at the buzzing windowpanes with a frown. The doorknob rattled sharply and the teacher leapt up, her face fixed in a rigid smile. She wrenched at the handle, keeping her pale face turned to the class; to comfort us, perhaps, or to prevent an outburst of giggling. The door opened a few inches and the headmaster's hand came through the gap, groping like a blind man's, while he kept up an urgent conversation with someone outside.

'Phone the parents,' we heard him say. 'Tell them to stay at home. The major said it's safest if we remain indoors.'

Then he began to murmur to Miss Charles, who clasped her hands to her chest and looked as if she were going to faint. The boys started to whisper. Some of the girls were drawing shaky breaths and one or two began to cry. Meanwhile, the noise in the distance had risen, become a steady, muted roar. Outside, tyres slid on the wet road. Orders were shouted, boots thumped on the pavement.

'It's the Natives,' declared my friend Rolie, 'they're coming,' and we rushed to the door that led out onto the balcony. Behind us Miss Charles, her legs weighed down by clumps of wailing girls, shouted for us to come back.

We packed the railing, pulling ourselves up to see. The street was full of activity and an assortment of vehicles; ivory-coloured police trucks, traffic-cop motorcycles and a blue bus with wire grilles on the windows were parked randomly across the roadway. The men had been formed into a line below us, naval blue beside policeman grey. They held rifles across their chests and looked from side to side at the men at either shoulder. The motorcycle cops in their boots and jodhpurs clutched pick-handles and fiddled with their pistol-holsters. Grim is the word, I thought, they look grim; but they shifted constantly in their straggling line, swallowing and swallowing. We could feel the plucking hands of the teachers as they tried to get us back indoors, hear their panted orders, but we eluded them, gripping the rails. The line of men began a stiff-legged walk down towards the corner where the street to the school turned up from the main road.

The distant sound had become a collection of individual shouts, a fragmented chanting. We leaned out as far as we could, craning our necks to see what was coming. The cordon of police and soldiers stood with their backs to us, blocking off our street. The sky shifted a notch further towards darkness and the leaves moved sideways in the cool gust before the rain. Suddenly there came the plaintive peep of a car-horn and the ranks divided around a small green Morris that chugged up the road towards the school.

(Continues…)


Excerpted from "Contact Wounds"
by .
Copyright © 2005 Jonathan Kaplan.
Excerpted by permission of Grove Atlantic, Inc..
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

Table of Contents

Prodrome,
1. Hereditary Conditions,
2. Desert Fever,
3. Morbid Anatomy,
4. Tropical Diseases,
5. Breathing Difficulties,
6. Homicide,
7. Natural Causes,
8. Bullet Rash,
9. Hospital-Acquired Infection,
10. Fragmentation Wounds,
11. Remission,

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